Provider Demographics
NPI:1437774148
Name:SMITH, BRANFORD JAMES (DDS)
Entity Type:Individual
Prefix:
First Name:BRANFORD
Middle Name:JAMES
Last Name:SMITH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 FILMORE ST
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70062-7813
Mailing Address - Country:US
Mailing Address - Phone:985-876-0448
Mailing Address - Fax:
Practice Address - Street 1:5934 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-1715
Practice Address - Country:US
Practice Address - Phone:504-234-9180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7082122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist